Other causes of failed PEth test for alchohol abuse?

Posted by gjones1956 @gjones1956, Nov 14, 2017

My daughter undergoes periodic peth testing for alchohol abuse. She fails regularly, although swears she drinks NOTHING. We have reason to believe she is telling the truth. Assuming she is indeed not drinking, is there a physical condition or ailment that might produce positive peth tests? She is 29, has enlarged lymph nodes, some kind of mysterious condition that gives her severe hives, etc. We are wondering if some type of autoinflammation or autoimmune condition might explain elevated levels. Our daughter is FINALLY discussing this with her regular doctor but if it is some unusual condition a specialist will be needed. The reason the peth test is required is due to a nasty custody dispute with lots of allegations of misconduct. I just want to know if there is ANYTHING other than alchohol consumption that can lead to positive test results. Any thoughts or knowledge of cases? Thanks for reading.

@yorkie0727

I joined specifically to comment in this group. I have regular and random alcohol use screening from two separate providers. I consistently pass GGT and CDT test but one provider decided to give me a PEth and Ethyl Glucuronide test. I passed the Ethyl Glucuronide test but had a 653 ng/mL PEth result well above the 20 ng/mL cutoff. Slightly worried and working on my rebuttal. Although this provider is not my primary care physician who actually handles and controls my case she can influence him. I just had an appointment with him and he has little concern about my abstinence. However, non-FDA approved testing can derail that apparently according to peoples posts.

I wanted to share this, it came directly from my lab results which I have full access to:
"Comments: Analyzed compound: PEth 16:0/18:1. 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanol. Analysis performed by Liquid Chromatography with Tandem Mass Spectrometry (LC/MS/MS). Detection limit: 20 ng/mL PEth levels in excess of 20 ng/mL are considered evidence of moderate to heavy ethanol consumption. However, the Center for Substance Abuse Treatment (CSAT) advises caution in interpretation and use of biomarkers alone to assess alcohol use. Results should be interpreted in the context of all available clinical and behavioral information. Reference: Substance Abuse and Mental Health Services Administration (2012). \"The Role of Biomarkers in the Treatment of Alcohol Use Disorders\", 2012 Revision. Advisory, Volume 11, Issue 2. This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration."

I hope the comments will help someone else bolster their case as to the lack of validity using PEth as a sole biomarker.

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The manufacturer itself says that a level of 100 nag/mL represents two binge sessions per day for 30 days. How is that even possible???

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In "theory" the PETH is not looking for the presence of Ethanol but rather the long-term biomarkers from it. If you believe the "theory" it would be entirely possible to pass an ETG with a few day look-back after not drinking near term but fail the PETH from "excessive" (and do not get me started on their baseline for that which is a couple drinks a day for a few days straight) drinking in the last 3 weeks.

I have read a lot about these tests and I think it is pretty clear they "may" have a value in proving (e.g. as a defense) total abstinence from Alcohol – but anything more than that is quackery… I personally think there is something very flawed with the test that is introduced in either testing or via some false-positive source that makes it only suitable to prove abstinence but not to prove guilt. They have little to know quantitative value (e.g. in proving how much you drank). The lack of independent objective testing and even LabCorps own disclaimer says a lot about the test…

Above all said – I watched a close family member fail these LabCorp PETH tests multiple times while not drinking. I had them start taking the same test at different test facilities – initially we found Request-a-Test which does a blood drawn PETH and they passed while failing the LabCorp one. As they continued to fail the LabCorp one I had the take the labcorp test at a different test facility also using labcorp. And watched them fail at the bad facility, pass at request a test, and pass at 3rd party LabCorp one. I do not have enough sample sets to in my mind prove the source of the fault but I can sure show something is screwy with the tests. The other person I know on this board having similar issues also had similar results (but only using labcorp and different facilities).

I am personally of the opinion more people need to take these tests multiple places (and ideally through multiple back-end labs) so we can build a big enough sample set to file a class action lawsuit against these people ruining people's lives with their sudo-science.

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@nnhightower

I have taken several PEth test through request a test and they are awful! I had to explain to them several time that it is a blood test, as they wanted to test my urine for the PEth test. I haven’t drank in almost 2 years and my levels were 220!!! It’s completely insane. I’m 5’6 and weigh 110 pounds. If my levels were actually that high I wouldn’t be able to function. There is definitely something wrong with the PEth test as I have passed every other test you can possibly take regarding alcohol.

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I do not remember what it was my family member had to tell request-a-test each time (so the people doing the draw could find the test in their computer) but agree they have a lot of problems in actual finding the PETH test in their system as most of their drug/alcohol testing is urine. It confused them nearly every time to do the PETH.

As for their test itself – all I can say is they passed every test at request a test from the blood draw, failed 80%+ at bad facility one using the finger prick LabCorp, and passed 100% of the ones at good facility using LabCorp. I will also advertise the methodology used between the two LabCorp collection places varied in subtle but possibly important ways.

I will take you at truth you failed the blood drawn one at Request-a-Test and should not have. That was not our experience – but we had plenty of experience with the fingerpricks at a specific test facility using LabCorp and false positives.

As I stated in several my other posts – I do not believe the PETH proves you drink. I think it has some false positives for specific things and thus is not accurate in proving you drank. I do think passing a PETH may prove you did not drink. ut that is not what the people sending people down for these tests are looking to do with it… and thus they are miss using it.

What I struggle more with is even if you accept the test as flawed in what it uses to "prove" alcohol use – why is the tests are not consistent in showing the same thing when taken on the same day using different and in cases the same methodology?

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@oledocfarmer

The manufacturer itself says that a level of 100 nag/mL represents two binge sessions per day for 30 days. How is that even possible???

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Where did you read that? I've been searching. I'm trying to compile some data on the test results to show how inconclusive they are. Everything I've found contradicts what some other article states regarding PEth levels.

For example, one article I found says that 100–500 ng/mL is a "very low" positive and could result from Previous heavy drinking (1–3 days), previous light drinking (12–36 hours), recent “extraneous exposure”.

However, another article states that "A positive PEth result is a reading of over 20ng/mL or above. This is equivalent to excessive alcohol abuse. It is considered that a result of over 100ng/mL is very strong evidence to suggest heavy binge drinking." It also says that Research has indicated that a PEth test can differentiate between incidental exposure (such as hand sanitizer) and the intentional consumption of alcohol.

So which is it? And where did this mystical 20 ng/mL cutoff come from? and if that is the "positive" cutoff how can 100 ng/mL be "very low positive"? This test is bunk. I am too new to this forum to be able to post the article links….sorry.

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@yorkie0727

Where did you read that? I've been searching. I'm trying to compile some data on the test results to show how inconclusive they are. Everything I've found contradicts what some other article states regarding PEth levels.

For example, one article I found says that 100–500 ng/mL is a "very low" positive and could result from Previous heavy drinking (1–3 days), previous light drinking (12–36 hours), recent “extraneous exposure”.

However, another article states that "A positive PEth result is a reading of over 20ng/mL or above. This is equivalent to excessive alcohol abuse. It is considered that a result of over 100ng/mL is very strong evidence to suggest heavy binge drinking." It also says that Research has indicated that a PEth test can differentiate between incidental exposure (such as hand sanitizer) and the intentional consumption of alcohol.

So which is it? And where did this mystical 20 ng/mL cutoff come from? and if that is the "positive" cutoff how can 100 ng/mL be "very low positive"? This test is bunk. I am too new to this forum to be able to post the article links….sorry.

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The 100-500 levels you’re quoting refer to the urine EtG test not the blood-based PEth test.

The 20 ng/mL cutoff is completely arbitrary. In Europe the cutoff is 35 ng/mL. Since the test purportedly can measure down to 0.0 ng/mL, spotting people that 20 ng/mL is the FOR-PROFIT manufacturers’ mendacious way of admitting that they really don’t know everything about PEth or how (and the conditions by which) it’s formed.

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@oledocfarmer

The 100-500 levels you’re quoting refer to the urine EtG test not the blood-based PEth test.

The 20 ng/mL cutoff is completely arbitrary. In Europe the cutoff is 35 ng/mL. Since the test purportedly can measure down to 0.0 ng/mL, spotting people that 20 ng/mL is the FOR-PROFIT manufacturers’ mendacious way of admitting that they really don’t know everything about PEth or how (and the conditions by which) it’s formed.

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Google PEth and “DNA Legal”….that should take you to a brochure containing the manufacturers’ guidelines for interpreting results. Guidelines unquestioningly followed by the third-party administrators and fourth-party interpreters.

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@nnhightower

I have taken several PEth test through request a test and they are awful! I had to explain to them several time that it is a blood test, as they wanted to test my urine for the PEth test. I haven’t drank in almost 2 years and my levels were 220!!! It’s completely insane. I’m 5’6 and weigh 110 pounds. If my levels were actually that high I wouldn’t be able to function. There is definitely something wrong with the PEth test as I have passed every other test you can possibly take regarding alcohol.

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I have MS. The enzyme that makes PEth (called PLD) is hyperactive as part of the MS disease process. Maybe your PLD enzyme is hyperactive too?

Liked by nnhightower

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@oledocfarmer

The 100-500 levels you’re quoting refer to the urine EtG test not the blood-based PEth test.

The 20 ng/mL cutoff is completely arbitrary. In Europe the cutoff is 35 ng/mL. Since the test purportedly can measure down to 0.0 ng/mL, spotting people that 20 ng/mL is the FOR-PROFIT manufacturers’ mendacious way of admitting that they really don’t know everything about PEth or how (and the conditions by which) it’s formed.

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@oledocfarmer My PEth test from request a test that used LabCorp was 227, not my EtG. I have passed every EtG and CDT test, but according to the PEth test, I must bing drink 4 times a day? Like I've previously stated…. I'm 5'6 and weigh 110 pounds. I don't think I could talk, much less function if these levels were acurate.

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@oledocfarmer

I have MS. The enzyme that makes PEth (called PLD) is hyperactive as part of the MS disease process. Maybe your PLD enzyme is hyperactive too?

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I will look into this… thank you!

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Completely agree. You are a textbook case of the unreliability of this test. Its use and application without more extensive, INDEPENDENT testing is at best unethical.

My prayer is that some government agency somewhere somehow will address this issue.

Liked by nnhightower

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@nnhightower

@oledocfarmer My PEth test from request a test that used LabCorp was 227, not my EtG. I have passed every EtG and CDT test, but according to the PEth test, I must bing drink 4 times a day? Like I've previously stated…. I'm 5'6 and weigh 110 pounds. I don't think I could talk, much less function if these levels were acurate.

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I will see if I can find the papers I read that talk about these numbers; at the lower levels they are very poor measures of quantities. It really all depends how much of the enzimes your body produces and how fast it breaks them down. Thus other than "maybe": are they are drinking a lot or a little- is the best they can get to quantify and even that is pretty skewed with no real published results to back that up from what I could find online after a huge amount of time looking.

Liked by nnhightower

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I doubt such information even exists. You’d need a large study (such as you would get in a standard FDA approval process) to work all those things out. The most PEth has a compelling biochemical theory/model….problem is there have been many, many compelling biochemical models in the past (e.g., lung cancer has been easily curable in rats for decades), but the models rarely work in reality the way they’re expected to work in theory. That’s why large, INDEPENDENT studies are necessary. The use of this test without such studies is unethical on its face.

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Hey is Mayo sponsoring this thread because it’s considering getting involved in this train wreck? We sure could use some help!

Liked by nnhightower

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@nnhightower

@oledocfarmer My PEth test from request a test that used LabCorp was 227, not my EtG. I have passed every EtG and CDT test, but according to the PEth test, I must bing drink 4 times a day? Like I've previously stated…. I'm 5'6 and weigh 110 pounds. I don't think I could talk, much less function if these levels were acurate.

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The PETH numbers do not directly correlate to blood alcohol level in a truly quantitative way. It is just an enzyme that is produced in response to your body processing alcohol (and in my belief some other things that cause these false positives). This number can be higher or lower for different people. Also the enzyme is broken down by different people at different rates (some of the studies said for instance less than 100% functional liver could effect how fast this happens). The number is greatly effected by how well or poorly your body breaks the enzymes down and is highly coupled to time in that regard as well.

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@oledocfarmer

Hey is Mayo sponsoring this thread because it’s considering getting involved in this train wreck? We sure could use some help!

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I think this is just an open forum for people to post and respond to health related questions they host… I would not read anything more into it than that. I honestly do not think anything will come of this without:

1) An independent researcher getting funding to do a lot of testing
2) A bunch of people that believe this test is flawed banding together with their existing questionable results and filing a lawsuit (Note: In my mind this is people that take the test same day and get different results from different places).

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